Provider Demographics
NPI:1568779130
Name:HEMPHILL, ERICA LEIGH (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:LEIGH
Last Name:HEMPHILL
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 S MAIN ST
Mailing Address - Street 2:UNIT 351
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-2908
Mailing Address - Country:US
Mailing Address - Phone:919-636-2996
Mailing Address - Fax:
Practice Address - Street 1:300 VEAZEY DR
Practice Address - Street 2:
Practice Address - City:BUTNER
Practice Address - State:NC
Practice Address - Zip Code:27509-1668
Practice Address - Country:US
Practice Address - Phone:919-764-2236
Practice Address - Fax:919-764-2182
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-02
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0072821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical